Growing Concerns of Dementia

Dementia is a syndrome which is usually chronic and characterized by a progressive, global deterioration in intellect including memory, learning, orientation, language, comprehension and judgement due to disease of the brain.

It is said to mainly affect older people. Only about 2% of cases start before the age of 65 years. Dementia is considered to be one of the major causes of disability in late-life.

Background

The Dementia Report 2010 has stated the following:

• In 2010, there were 3.7 million Indians with dementia and the total societal cost is about 14,700 crores.
• The numbers are expected to double by 2030 cost would increase three times.

Also, The World Alzheimer Report 2015 led by King’s College London has stated that out of 47 million people living with dementia, 4.1 million live in India.

Government initiatives for older persons

With respect to Dementia, India does not yet have a National Dementia Policy. However, there are three main initiatives in India, which are aimed at elder care/ support and health and include some specific dementia-related initiatives in them. These are:

Scheme of Integrated Programme for Older Persons (IPOP)

This is a central sector scheme in order to improve the quality of life of the Older Personsunder this, financial assistance is provided to State Governments/ Panchayati Raj Institutions/ Urban Local Bodies and Non Governmental Organisations for running and maintenance of projects related to elders, such as setting up old age homes, day care centres, mobile units, helplines and counselling centres, etc. Day care, helpline, counseling, and old age homes for persons with dementia fall under the purview of this scheme.

National Programme for the Health Care for the Elderly (NPHCE)

This scheme is under the Ministry of Health and Family Welfare. It includes multiple ways to improve healthcare for the elderly, through better education in geriatric medicine, setting up community-based primary centres and better district centres, as well as dedicated facilities and special beds for the elderly. Initiatives to train healthcare professionals for dementia, setting aside beds for persons with dementia, and other such areas, shall fall in the purview of this national programme.

Indira Gandhi National Old Age Pension Scheme (IGNOAPS) and other such schemes

These are part of the National Social Assistance Programme(NSAP) (under Ministry of Rural Development). These do not have any direct, additional support for persons with dementia, but are still important because any special support for persons with dementia based on poverty or pension schemes may fall in this purview.

Way forward

Some efforts in the following way can be undertaken to address the issue of Dementia progressively:

• The recent Mental Healthcare Bill can have a large impact on the persons facing dementia. It would mean as to the way mental illness is defined and which sections of this act may be including/ excluding persons with various types of dementia, and how dementia may be seen as affecting mental capacity and other such aspects.
• Also disabilities which falls under the Ministry of Social Welfare and Empowerment may include persons with mental illness, and mental illness may be defined to include dementia.
• A legislation related to Maintenance and Welfare of Parents and Senior Citizens under the Ministry of Social Justice and Empowerment can spell out the role of families coping with dementia.
• Efforts such as Dementia Awareness Month which is been held in Australia having a theme ‘you are not alone’ must be replicated even by India in order to address the growing concern of Dementia.